Posts Tagged ‘COBRA’

The Florida Times-Union recently ran a story about how much Jacksonville-area hospitals write off in “charity care” every year. http://bit.ly/av7Qbf

Not surprisingly, the amount increased dramatically last year over 2008. St. Vincent’s had the biggest increase at almost 30%. Orange Park saw a 19% increase, while Memorial soaked up more than a 15% increase ($133 million).

“Charity care” simply means the cost of treating uninsured patients who come to the emergency room and can’t pay their bills. The hospitals are required by law to treat these patients, but I suspect that a good portion of them don’t really have emergencies in the traditional sense of the term; they have emergencies in the sense that they are desperate for medical care but can’t afford to see a doctor.

Some of these people have lost their job and the health insurance that went along with it. With no income, they can’t afford to pay the premium to extend their coverage through COBRA, even with the government subsidy. Some of them have a job that doesn’t provide health insurance, and yet they don’t qualify for Medicaid. Some of them are unable to work because of their health problems, and they’re in the midst of the excruciatingly long application process for Social Security disability benefits or SSI.

We see people like this in our office every day. In Duval County, we are lucky to have the indigent care program at Shands, which covers many low-income people who don’t have insurance. This is a taxpayer-funded program that fills in the gaps in the health insurance system for people who live in Jacksonville. For people who live in the surrounding counties, the resources are far more limited, making it impossible for many to get any kind of treatment.

Our patchwork health care system leaves a lot of people out, and the numbers are growing every day with the downturn in the economy. I certainly don’t have all the answers, but I see the problems in my office every day. The status quo just doesn’t seem to be working for everyone.

A news article from Associated Press reports today that the newly-proposed health care legislation does not eliminate the rule that people awarded Social Security disability (SSDI) benefits have to wait two years to get Medicare coverage, a change that disabled people and disability advocates were pushing for. Such a change would certainly benefit our clients, and I’m sorry to find out that it won’t be part of the new bill.

Typically, people apply for disability benefits right after they get sick or injured, because they’re unable to work. Even if their prior job provided health insurance, most people can’t afford the cost of COBRA. Some lucky people have access to health insurance through a spouse, but the rest are left to their own devices while their disability application is processed through the Social Security Administration. This long, torturous adventure full of red tape can take up to two years (sometimes even longer). In the meantime, many applicants have trouble getting access to health care. They have no income (or they’re relying on one income instead of two) and no insurance. Then, when they are finally awarded benefits, they still have to wait for Medicare to kick in. They still have to wait to see a doctor! Meanwhile, their conditions get worse because they haven’t been able to afford treatment and medications.

These hard-working people, through no fault of their own, don’t have the “luxury” of access to health care during a time when it’s critically important. Should access to health care be a luxury reserved for the lucky and the affluent? I don’t think so.